Why is this drug prescribed?

Exelon capsules and oral solution both contain the active ingredient rivastigmine, which is a type of drug called an acetylcholinesterase inhibitor. It works by slowing the breakdown of a compound in the brain called acetylcholine. Acetylcholine is a natural compound known as a neurotransmitter. Neurotransmitters are stored in nerve cells in the brain and nervous system, and are involved in transmitting messages between the nerve cells. They are necessary for the normal functioning of the brain and nervous system. Acetylcholine in the brain is continually being released by nerve cells, and then broken down by another natural chemical called acetylcholinesterase. One of the features of both Alzheimer's disease and Parkinson's disease appears to be a lower than normal level of acetylcholine in the brain. This is due in part to degeneration of brain cells, in particular those that normally release acetylcholine. Rivastigmine increases the level of acetylcholine in the brain. It does this by preventing the action of acetylcholinesterase, the compound which normally breaks it down. This slows the breakdown of acetylcholine that is released from remaining undamaged nerve cells in the brain. The result of this is increased activity of acetylcholine in the brain. This improves the cognitive processes of thinking, learning and memory, and improves the symptoms of dementia and daily functioning in Alzheimer's disease. Rivastigmine is used to treat mild to moderately severe dementia in people with Alzheimer's disease or Parkinson's disease. However, it only slows the worsening of the dementia, rather than being a cure. If the drug has not slowed the worsening of symptoms after three months of treatment at the maintenance dose, it should be stopped. For patients who continue treatment, the benefit of the drug should be reassessed on a regular basis and stopped when it is considered that the drug is no longer providing a beneficial effect.

Treatments

* Mild to moderately severe Alzheimer's dementia * Mild to moderately severe dementia in people with Parkinson's disease

What side effects can this drug cause?

* Disturbances of the gut such as nausea, vomiting, diarrhoea, indigestion or abdominal pain * Decreased appetite and weight loss * Dizziness * Increased sweating * Fatigue * Weakness or loss of strength * Agitation * Headache * Sleepiness * Shaking, usually of the hands * Confusion * Difficulty in sleeping * Depression * Fainting * Ulceration of the stomach or intestine * Seizures * Chest pain * Rash * False perceptions of things that are not really there * Worsening of Parkinson's symptoms * Abnormal heart beats